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Fausto Biancari - One of the best experts on this subject based on the ideXlab platform.
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Validation of EuroSCORE II in Patients Undergoing Coronary Artery Bypass Surgery
The Annals of thoracic surgery, 2012Co-Authors: Fausto Biancari, Francesco Vasques, Reija Mikkola, Marta Martin, Jarmo Lahtinen, Jouni HeikkinenAbstract:Background The European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) has been recently developed to improve the performance of the original EuroSCORE. Herein we evaluated its discriminatory ability in predicting the immediate and late outcome after coronary artery bypass grafting (CABG). Methods Complete data on 1,027 patients who underwent isolated CABG were available for validation of EuroSCORE II and to compare its discriminatory ability with the original EuroSCORE and its Finnish modified version. Results EuroSCORE II performed somewhat better (area under the curve [AUC] 0.852, Brier score 0.031) than the original logistic EuroSCORE (AUC 0.838, Brier score 0.034) and its Finnish modified version (AUC 0.825, Brier score 0.034) in predicting operative mortality. The overall expected-to-observed operative mortality ratio for the original logistic EuroSCORE was 1.8, for its Finnish modified version was 0.6, and for EuroSCORE II was 1.2. EuroSCORE II showed expected-to-observed ratios ranging from 1.05 to 1.17 in its highest third quintiles. The best cutoff of EuroSCORE II in predicting operative postoperative mortality was 10% (21.5% vs 1.6%, p p Conclusions The EuroSCORE II performs better than its original version in predicting operative mortality and morbidity after isolated CABG. Its ability to predict 30-day mortality in high-risk patients is of particular importance. The EuroSCORE II is also a good predictor of late postoperative survival.
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External Validation of Modified EuroSCORE
World journal of surgery, 2010Co-Authors: Fausto Biancari, Juha Nissinen, Jan-ola Wistbacka, Jari Laurikka, Matti TarkkaAbstract:EuroSCORE is an adult cardiac surgery risk scoring method that is used worldwide, which has been shown to significantly overestimate the operative risk. We derived a new risk scoring method by modifying some of the risk factors included in the EuroSCORE algorithm and we validated it in an external database. This study included 4,014 patients who underwent adult cardiac surgery at the Heart Centre, Tampere University Hospital, Finland. Operative risk was estimated by EuroSCORE and its modified version. In-hospital postoperative mortality rate was 3.2%. EuroSCORE (AUC for logistic EuroSCORE 0.82; 95% confidence interval (CI), 0.79-0.85) and modified score (AUC for logistic modified score 0.79; 95% CI, 0.75-0.83) performed well in predicting in-hospital mortality in this series. The mean logistic EuroSCORE was 8%, and the mean logistic modified score was 2.2%. Thus, the observed to expected ratio for in-hospital mortality was 0.4 for logistic EuroSCORE and 1.5 for logistic modified score. The difference between observed and predicted mortality rate matched correctly for increasing additive modified score, but not for EuroSCORE. The observed to predicted ratio in high-risk patients (within the 90th percentile of each risk algorithm) was 0.36 (13.2%/36.2% in 402 patients) for logistic EuroSCORE and 0.99 (14.7%/14.9% in 395 patients) for logistic modified score. This modified and simplified score, which includes most of EuroSCORE variables, seems to provide a more realistic estimation of postoperative mortality risk of patients undergoing any adult cardiac surgery.
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EuroSCORE predicts health-related quality of life after coronary artery bypass grafting.
Interactive cardiovascular and thoracic surgery, 2008Co-Authors: Pertti Loponen, Fausto Biancari, Michael Luther, Juha Nissinen, Jan-ola Wistbacka, Jari Laurikka, Harri Sintonen, Matti TarkkaAbstract:Three hundred and two patients were evaluated for the EuroSCORE risk and health-related quality of life (HRQoL) during three years after CABG as assessed by the 15D instrument. Both additive and logistic EuroSCORE correlated significantly with the 15D score at 6, 18 and 36 months. A clinically important increase > or =0.03 in the 15D score was achieved by 50.6% of patients at 6 months, 40.0% at 18 months and 35.9% at 36 months. The rates were similar among patients with increasing EuroSCORE at 6 and 18 months, but tended to decrease at 36 months in the highest EuroSCORE group (EuroSCORE 0-2: 46.8%; 3-5: 34.8%; and 6-14: 33.3%, respectively, P=0.13). Both additive (area under the receiver operating characteristic curve, AUC: 0.582, P=0.024) and logistic EuroSCORE (AUC: 0.575, P=0.039) were predictors of a significant increase of the 15D score. The best cut-off value of the additive EuroSCORE for prediction of a clinically important improvement of the 15D score during 3-year follow-up was 3, as 46.7% of patients with EuroSCORE 0-3 and 30.1% of patients with a score >3 (P=0.006) improved clinically. The present study showed that the EuroSCORE also predicts long-term HRQoL after CABG.
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EuroSCORE predicts immediate and late outcome after coronary artery bypass surgery
The Annals of Thoracic Surgery, 2006Co-Authors: Fausto Biancari, Olli-pekka Kangasniemi, Johannes Luukkonen, Sailaritta Vuorisalo, Jari Satta, R Pokela, Tatu JuvonenAbstract:Background The European system for cardiac operative risk evaluation score (EuroSCORE) has been shown to be of value in identifying patients at high risk for adverse immediate postoperative outcome after adult cardiac surgery. The aim of the present study was to evaluate EuroSCORE in predicting the 12-year outcome of patients who underwent on-pump coronary artery bypass surgery (CABG). Methods We calculated the EuroSCORE in 917 patients who underwent CABG. The median follow-up was 11.7 years. Results Both additive and logistic EuroSCORE had an area under the receiver operating characteristic curve of 0.856 for prediction of 30-day postoperative death. Among 912 operative survivors, the 10-year survival rates according to quintiles of additive EuroSCORE were 87.9%, 83.9%, 85.2%, 76.0%, and 51.3% (p Conclusions EuroSCORE is a relevant predictor of immediate and late outcome after on-pump CABG.
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EuroSCORE predicts immediate and late outcome after coronary artery bypass surgery
The Annals of thoracic surgery, 2006Co-Authors: Fausto Biancari, Olli-pekka Kangasniemi, Johannes Luukkonen, Sailaritta Vuorisalo, Jari Satta, Pokela R, Tatu JuvonenAbstract:The European system for cardiac operative risk evaluation score (EuroSCORE) has been shown to be of value in identifying patients at high risk for adverse immediate postoperative outcome after adult cardiac surgery. The aim of the present study was to evaluate EuroSCORE in predicting the 12-year outcome of patients who underwent on-pump coronary artery bypass surgery (CABG). We calculated the EuroSCORE in 917 patients who underwent CABG. The median follow-up was 11.7 years. Both additive and logistic EuroSCORE had an area under the receiver operating characteristic curve of 0.856 for prediction of 30-day postoperative death. Among 912 operative survivors, the 10-year survival rates according to quintiles of additive EuroSCORE were 87.9%, 83.9%, 85.2%, 76.0%, and 51.3% (p < 0.0001). The 10-year survival rates according to quintiles of logistic EuroSCORE were 87.9%, 85.4%, 86.5%, 76.9%, and 58.9% (p < 0.0001). EuroSCORE is a relevant predictor of immediate and late outcome after on-pump CABG.
Ioannis K Toumpoulis - One of the best experts on this subject based on the ideXlab platform.
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does EuroSCORE predict length of stay and specific postoperative complications after coronary artery bypass grafting
International Journal of Cardiology, 2005Co-Authors: Ioannis K Toumpoulis, Constantine E Anagnostopoulos, Joseph J Derose, Daniel G SwistelAbstract:Abstract Background To evaluate the performance of EuroSCORE in the prediction of in-hospital postoperative length of stay and specific major postoperative complications after coronary artery bypass grafting (CABG). Methods Data on 3760 consecutive patients with CABG were prospectively collected. The EuroSCORE model (standard and logistic) was used to predict in-hospital mortality, prolonged length of stay (>12 days) and major postoperative complications (stroke, myocardial infarction, sternal infection, bleeding, sepsis and/or endocarditis, gastrointestinal complications, renal and respiratory failure). A C statistic (receiver operating characteristic curve) was used to test the discrimination of the EuroSCORE. The calibration of the model was assessed by the Hosmer–Lemeshow goodness-of-fit statistic. Results In-hospital mortality was 2.7%, and 13.7% of patients had one or more major complications. EuroSCORE showed very good discriminatory ability in predicting renal failure ( C statistic: 0.80) and good discriminatory ability in predicting in-hospital mortality ( C statistic: 0.75), sepsis and/or endocarditis ( C statistic: 0.72) and prolonged length of stay ( C statistic: 0.71). There were no differences in terms of the discriminatory ability between standard and logistic EuroSCORE. Standard EuroSCORE showed good calibration (Hosmer–Lemeshow: P >0.05) in predicting these outcomes except for postoperative length of stay, while logistic EuroSCORE showed good calibration only in predicting renal failure. Conclusions EuroSCORE can be used to predict not only in-hospital mortality, for which it was originally designed, but also prolonged length of stay and specific postoperative complications such as renal failure and sepsis and/or endocarditis after CABG. These outcomes can be predicted accurately using the standard EuroSCORE which is very simple and easy in its calculation.
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EuroSCORE predicts long term mortality after heart valve surgery
The Annals of Thoracic Surgery, 2005Co-Authors: Ioannis K Toumpoulis, Constantine E Anagnostopoulos, Stavros K Toumpoulis, Joseph J Derose, Daniel G SwistelAbstract:Background The European System for Cardiac Operative Risk Evaluation (EuroSCORE) is the most rigorously evaluated scoring system in cardiac surgery. We sought to evaluate the performance of EuroSCORE in the prediction of long-term mortality in patients undergoing heart valve surgery. Methods Medical records of patients with isolated or combined heart valve surgery, who were discharged alive (n = 1035), were retrospectively reviewed. Their operative surgical risks were calculated according to EuroSCORE model (standard and logistic). Long-term survival data (mean follow-up 4.5 ± 3.1 years) were obtained from the National Death Index. Kaplan-Meier curves of the quartiles of standard and logistic EuroSCORE were plotted. Results The estimated 5-year survival rates of the quartiles in the standard and logistic EuroSCORE model were: 90.0% ± 2.3%, 85.1% ± 2.3%, 64.8% ± 3.3%, and 55.1% ± 3.7% ( p p Conclusions EuroSCORE can be used to predict not only in-hospital mortality, for which it was originally designed, but also long-term mortality in the whole context of heart valve surgery. This outcome can be predicted using the standard EuroSCORE, which is very simple and easy in its calculation.
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Does EuroSCORE predict length of stay and specific postoperative complications after heart valve surgery
The Journal of heart valve disease, 2005Co-Authors: Ioannis K Toumpoulis, Constantine E AnagnostopoulosAbstract:Background and aim of the study EuroSCORE is the most rigorously evaluated scoring system in cardiac surgery. The study aim was to evaluate the performance of EuroSCORE in the prediction of in-hospital postoperative length of stay and specific major postoperative complications after heart valve surgery. Methods Data obtained from 1,105 consecutive patients who underwent isolated or combined heart valve surgery were collected prospectively. The EuroSCORE model (standard and logistic) was used to predict in-hospital mortality, prolonged length of stay (> 20 days) and major postoperative complications. A C statistic (receiver operating characteristic curve) was used to test discrimination of the EuroSCORE. Calibration of the model was assessed by the Hosmer-Lemeshow goodness-of-fit statistic. Results In-hospital mortality was 6.3%, and 21.7% of patients had one or more major complication. EuroSCORE showed very good discriminatory ability in predicting postoperative renal failure (C statistic: 0.78) and good discriminatory ability in predicting in-hospital mortality (C statistic: 0.72), prolonged length of stay (C statistic: 0.71), stroke over 24 h (C statistic: 0.73), gastrointestinal complications (C statistic: 0.73) and respiratory failure (C statistic: 0.71). There were no differences in terms of the discriminatory ability between standard and logistic EuroSCORE. The standard EuroSCORE model showed good calibration in predicting these outcomes (Hosmer-Lemeshow: p > 0.05). The logistic EuroSCORE model showed good calibration, except for prolonged length of stay and respiratory failure. Conclusion EuroSCORE can be used to predict not only in-hospital mortality, for which it was originally designed, but also prolonged length of stay and specific postoperative complications such as renal failure, stroke over 24 h, gastrointestinal complications and respiratory failure within the whole context of heart valve surgery. These outcomes can be predicted accurately using the standard EuroSCORE, which is very easily calculated.
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EuroSCORE Predicts Long-Term Mortality After Heart Valve Surgery
The Annals of thoracic surgery, 2005Co-Authors: Ioannis K Toumpoulis, Constantine E Anagnostopoulos, Stavros K Toumpoulis, Joseph J Derose, Daniel G SwistelAbstract:The European System for Cardiac Operative Risk Evaluation (EuroSCORE) is the most rigorously evaluated scoring system in cardiac surgery. We sought to evaluate the performance of EuroSCORE in the prediction of long-term mortality in patients undergoing heart valve surgery. Medical records of patients with isolated or combined heart valve surgery, who were discharged alive (n = 1035), were retrospectively reviewed. Their operative surgical risks were calculated according to EuroSCORE model (standard and logistic). Long-term survival data (mean follow-up 4.5 +/- 3.1 years) were obtained from the National Death Index. Kaplan-Meier curves of the quartiles of standard and logistic EuroSCORE were plotted. The estimated 5-year survival rates of the quartiles in the standard and logistic EuroSCORE model were: 90.0% +/- 2.3%, 85.1% +/- 2.3%, 64.8% +/- 3.3%, and 55.1% +/- 3.7% (p < 0.0001, log-rank test with adjustment for trend) and 90.4% +/- 2.2%, 86.4% +/- 2.5%, 66.9% +/- 3.3%, and 56.1% +/- 3.3% (p < 0.0001, log-rank test with adjustment for trend) respectively. The odds of death in the highest-risk quartile were 7.46- and 7.82-fold higher than the odds of death in the lowest-risk quartile for standard and logistic EuroSCORE respectively. EuroSCORE can be used to predict not only in-hospital mortality, for which it was originally designed, but also long-term mortality in the whole context of heart valve surgery. This outcome can be predicted using the standard EuroSCORE, which is very simple and easy in its calculation.
Daniel G Swistel - One of the best experts on this subject based on the ideXlab platform.
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does EuroSCORE predict length of stay and specific postoperative complications after coronary artery bypass grafting
International Journal of Cardiology, 2005Co-Authors: Ioannis K Toumpoulis, Constantine E Anagnostopoulos, Joseph J Derose, Daniel G SwistelAbstract:Abstract Background To evaluate the performance of EuroSCORE in the prediction of in-hospital postoperative length of stay and specific major postoperative complications after coronary artery bypass grafting (CABG). Methods Data on 3760 consecutive patients with CABG were prospectively collected. The EuroSCORE model (standard and logistic) was used to predict in-hospital mortality, prolonged length of stay (>12 days) and major postoperative complications (stroke, myocardial infarction, sternal infection, bleeding, sepsis and/or endocarditis, gastrointestinal complications, renal and respiratory failure). A C statistic (receiver operating characteristic curve) was used to test the discrimination of the EuroSCORE. The calibration of the model was assessed by the Hosmer–Lemeshow goodness-of-fit statistic. Results In-hospital mortality was 2.7%, and 13.7% of patients had one or more major complications. EuroSCORE showed very good discriminatory ability in predicting renal failure ( C statistic: 0.80) and good discriminatory ability in predicting in-hospital mortality ( C statistic: 0.75), sepsis and/or endocarditis ( C statistic: 0.72) and prolonged length of stay ( C statistic: 0.71). There were no differences in terms of the discriminatory ability between standard and logistic EuroSCORE. Standard EuroSCORE showed good calibration (Hosmer–Lemeshow: P >0.05) in predicting these outcomes except for postoperative length of stay, while logistic EuroSCORE showed good calibration only in predicting renal failure. Conclusions EuroSCORE can be used to predict not only in-hospital mortality, for which it was originally designed, but also prolonged length of stay and specific postoperative complications such as renal failure and sepsis and/or endocarditis after CABG. These outcomes can be predicted accurately using the standard EuroSCORE which is very simple and easy in its calculation.
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EuroSCORE predicts long term mortality after heart valve surgery
The Annals of Thoracic Surgery, 2005Co-Authors: Ioannis K Toumpoulis, Constantine E Anagnostopoulos, Stavros K Toumpoulis, Joseph J Derose, Daniel G SwistelAbstract:Background The European System for Cardiac Operative Risk Evaluation (EuroSCORE) is the most rigorously evaluated scoring system in cardiac surgery. We sought to evaluate the performance of EuroSCORE in the prediction of long-term mortality in patients undergoing heart valve surgery. Methods Medical records of patients with isolated or combined heart valve surgery, who were discharged alive (n = 1035), were retrospectively reviewed. Their operative surgical risks were calculated according to EuroSCORE model (standard and logistic). Long-term survival data (mean follow-up 4.5 ± 3.1 years) were obtained from the National Death Index. Kaplan-Meier curves of the quartiles of standard and logistic EuroSCORE were plotted. Results The estimated 5-year survival rates of the quartiles in the standard and logistic EuroSCORE model were: 90.0% ± 2.3%, 85.1% ± 2.3%, 64.8% ± 3.3%, and 55.1% ± 3.7% ( p p Conclusions EuroSCORE can be used to predict not only in-hospital mortality, for which it was originally designed, but also long-term mortality in the whole context of heart valve surgery. This outcome can be predicted using the standard EuroSCORE, which is very simple and easy in its calculation.
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EuroSCORE Predicts Long-Term Mortality After Heart Valve Surgery
The Annals of thoracic surgery, 2005Co-Authors: Ioannis K Toumpoulis, Constantine E Anagnostopoulos, Stavros K Toumpoulis, Joseph J Derose, Daniel G SwistelAbstract:The European System for Cardiac Operative Risk Evaluation (EuroSCORE) is the most rigorously evaluated scoring system in cardiac surgery. We sought to evaluate the performance of EuroSCORE in the prediction of long-term mortality in patients undergoing heart valve surgery. Medical records of patients with isolated or combined heart valve surgery, who were discharged alive (n = 1035), were retrospectively reviewed. Their operative surgical risks were calculated according to EuroSCORE model (standard and logistic). Long-term survival data (mean follow-up 4.5 +/- 3.1 years) were obtained from the National Death Index. Kaplan-Meier curves of the quartiles of standard and logistic EuroSCORE were plotted. The estimated 5-year survival rates of the quartiles in the standard and logistic EuroSCORE model were: 90.0% +/- 2.3%, 85.1% +/- 2.3%, 64.8% +/- 3.3%, and 55.1% +/- 3.7% (p < 0.0001, log-rank test with adjustment for trend) and 90.4% +/- 2.2%, 86.4% +/- 2.5%, 66.9% +/- 3.3%, and 56.1% +/- 3.3% (p < 0.0001, log-rank test with adjustment for trend) respectively. The odds of death in the highest-risk quartile were 7.46- and 7.82-fold higher than the odds of death in the lowest-risk quartile for standard and logistic EuroSCORE respectively. EuroSCORE can be used to predict not only in-hospital mortality, for which it was originally designed, but also long-term mortality in the whole context of heart valve surgery. This outcome can be predicted using the standard EuroSCORE, which is very simple and easy in its calculation.
Heinz Jakob - One of the best experts on this subject based on the ideXlab platform.
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Does the EuroSCORE equally well predict perioperative cardiac surgical risk for men and women
Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy, 2011Co-Authors: Parwis Massoudy, Jochen Sander, Daniel Wendt, Matthias Thielmann, Heinz Jakob, Stefan Herget-rosenthalAbstract:The EuroSCORE is a widely applied scoring system to estimate perioperative risk in patients undergoing cardiac surgery. It acknowledges an increased risk in women but does not apply a gender-specific weighing of individual risk indicators. We separately investigated the performance of the EuroSCORE for men and women. Cardiac surgical patients operated in 2002 and 2003 (n = 1930) served as training group. Patients operated in 2004 served as validation group (n = 870). Using binary regression analysis, we developed a gender-specific model on the basis of the original EuroSCORE risk indicators. The individual risk indicators were assigned gender-specific correlation coefficients. Applying ROC analysis to the validation group, the original EuroSCORE performed well, with an area under curve (AUC) of 0.758, for men but poor, with an AUC 0.676, for women. After gender-specific re-weighing, ROC analysis revealed considerably improved predictive values of the modified EuroSCORE. AUC for women increased to 0.755, AUC for men further increased to 0.772. The original EuroSCORE failed to accurately predict perioperative mortality in women. A binary regression model, assigning a gender-specific weight to each of the risk indicators of the original EuroSCORE, considerably improved the predictive power of the modified EuroSCORE.
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The EuroSCORE - still helpful in patients undergoing isolated aortic valve replacement?
Interactive cardiovascular and thoracic surgery, 2009Co-Authors: Daniel Wendt, Parwis Massoudy, Matthias Thielmann, Brigitte R. Osswald, Katrin Kayser, Paschalis Tossios, Markus Kamler, Heinz JakobAbstract:BACKGROUND The European System for Cardiac Operative Risk Evaluation (EuroSCORE) is one of the most prominent scores used for the evaluation of predicted mortality in cardiac surgery. The aim of our study was to analyze the logistic and additive EuroSCORE in view of its accuracy for patients undergoing isolated aortic valve replacement (AVR). METHODS A total of 652 patients underwent isolated AVR from January 1999 to June 2007. Emergency and redo operations were included. Acute endocarditis was excluded. Out of logistic regression analyses, receiver operating characteristic (ROC) curve statistics were calculated both for the logistic and additive EuroSCORE. RESULTS By using the identical variables used in the EuroSCORE, the area under curve was 70.7% for the logistic and 72.4% for the additive EuroSCORE, respectively. If age, which is by nature positively correlated with increasing cardiac and non-cardiac comorbidity, is calculated as a single parameter, the area under curve remains at 69.9% being very close to the result of the EuroSCORE. CONCLUSIONS For the subgroup of patients undergoing isolated AVR, the use of the EuroSCORE provides a comparable precision concerning the estimation of early mortality compared with the simple factor 'age'. The extended use of the EuroSCORE in view of percutaneous AVR, the insufficient accuracy of the score bears the risk of incorrect decision-making.
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society of thoracic surgeons score is superior to the EuroSCORE determining mortality in high risk patients undergoing isolated aortic valve replacement
The Annals of Thoracic Surgery, 2009Co-Authors: Daniel Wendt, Parwis Massoudy, Matthias Thielmann, Brigitte R. Osswald, Katrin Kayser, Paschalis Tossios, Markus Kamler, Heinz JakobAbstract:Background Major scores for the evaluation of procedural risk in cardiac surgery are the European system for cardiac operative risk evaluation score (EuroSCORE), the Society of Thoracic Surgeons (STS) score, and the Parsonnet score. The aim of our study was to analyze the predictive value of these scores in "high risk" patients undergoing isolated aortic valve replacement (AVR). Methods Six hundred and fifty-two patients underwent isolated AVR from January 1999 through June 2007. Emergency and redo operations were included; acute endocarditis was excluded. Evaluation was performed by logistic regression analysis. Data collection was prospective. Results The mean logistic EuroSCORE of all patients was 8.5 ± 7.9%, the mean STS score was 4.4 ± 3.9%, and the mean logistic Parsonnet score was 9.8 ± 8.5%. In-hospital mortality was 2.5% (n = 16). Freedom from all-cause death was 93.4% at 1 year, 90.2% at 2 years, and 75.8% at 5 years, respectively. A total of 182 patients had a logistic EuroSCORE greater than 10. For the group of patients with a EuroSCORE between 10% and 20% (n = 130) the mean EuroSCORE was 13.9 ± 2.8% and the STS score was 6.5 ± 3.8%. Observed mortality was 4.6% in this group. For the 52 patients with a logistic EuroSCORE of at least 20 (mean 28.5 ± 10.3%, STS score 10.1 ± 7.3%) the observed mortality was 3.9% (n = 2). By stepwise logistic regression, none of the EuroSCORE variables could be identified as an independent predictor in the "high- risk" group. Conclusions The logistic EuroSCORE was primarily created to allow patient grouping for the total spectrum of cardiac surgery. In patients undergoing isolated AVR, the EuroSCORE highly overestimates mortality, whereas the STS score seems to be actually more suitable in assessing perioperative mortality for these patients.
Constantine E Anagnostopoulos - One of the best experts on this subject based on the ideXlab platform.
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does EuroSCORE predict length of stay and specific postoperative complications after coronary artery bypass grafting
International Journal of Cardiology, 2005Co-Authors: Ioannis K Toumpoulis, Constantine E Anagnostopoulos, Joseph J Derose, Daniel G SwistelAbstract:Abstract Background To evaluate the performance of EuroSCORE in the prediction of in-hospital postoperative length of stay and specific major postoperative complications after coronary artery bypass grafting (CABG). Methods Data on 3760 consecutive patients with CABG were prospectively collected. The EuroSCORE model (standard and logistic) was used to predict in-hospital mortality, prolonged length of stay (>12 days) and major postoperative complications (stroke, myocardial infarction, sternal infection, bleeding, sepsis and/or endocarditis, gastrointestinal complications, renal and respiratory failure). A C statistic (receiver operating characteristic curve) was used to test the discrimination of the EuroSCORE. The calibration of the model was assessed by the Hosmer–Lemeshow goodness-of-fit statistic. Results In-hospital mortality was 2.7%, and 13.7% of patients had one or more major complications. EuroSCORE showed very good discriminatory ability in predicting renal failure ( C statistic: 0.80) and good discriminatory ability in predicting in-hospital mortality ( C statistic: 0.75), sepsis and/or endocarditis ( C statistic: 0.72) and prolonged length of stay ( C statistic: 0.71). There were no differences in terms of the discriminatory ability between standard and logistic EuroSCORE. Standard EuroSCORE showed good calibration (Hosmer–Lemeshow: P >0.05) in predicting these outcomes except for postoperative length of stay, while logistic EuroSCORE showed good calibration only in predicting renal failure. Conclusions EuroSCORE can be used to predict not only in-hospital mortality, for which it was originally designed, but also prolonged length of stay and specific postoperative complications such as renal failure and sepsis and/or endocarditis after CABG. These outcomes can be predicted accurately using the standard EuroSCORE which is very simple and easy in its calculation.
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EuroSCORE predicts long term mortality after heart valve surgery
The Annals of Thoracic Surgery, 2005Co-Authors: Ioannis K Toumpoulis, Constantine E Anagnostopoulos, Stavros K Toumpoulis, Joseph J Derose, Daniel G SwistelAbstract:Background The European System for Cardiac Operative Risk Evaluation (EuroSCORE) is the most rigorously evaluated scoring system in cardiac surgery. We sought to evaluate the performance of EuroSCORE in the prediction of long-term mortality in patients undergoing heart valve surgery. Methods Medical records of patients with isolated or combined heart valve surgery, who were discharged alive (n = 1035), were retrospectively reviewed. Their operative surgical risks were calculated according to EuroSCORE model (standard and logistic). Long-term survival data (mean follow-up 4.5 ± 3.1 years) were obtained from the National Death Index. Kaplan-Meier curves of the quartiles of standard and logistic EuroSCORE were plotted. Results The estimated 5-year survival rates of the quartiles in the standard and logistic EuroSCORE model were: 90.0% ± 2.3%, 85.1% ± 2.3%, 64.8% ± 3.3%, and 55.1% ± 3.7% ( p p Conclusions EuroSCORE can be used to predict not only in-hospital mortality, for which it was originally designed, but also long-term mortality in the whole context of heart valve surgery. This outcome can be predicted using the standard EuroSCORE, which is very simple and easy in its calculation.
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Does EuroSCORE predict length of stay and specific postoperative complications after heart valve surgery
The Journal of heart valve disease, 2005Co-Authors: Ioannis K Toumpoulis, Constantine E AnagnostopoulosAbstract:Background and aim of the study EuroSCORE is the most rigorously evaluated scoring system in cardiac surgery. The study aim was to evaluate the performance of EuroSCORE in the prediction of in-hospital postoperative length of stay and specific major postoperative complications after heart valve surgery. Methods Data obtained from 1,105 consecutive patients who underwent isolated or combined heart valve surgery were collected prospectively. The EuroSCORE model (standard and logistic) was used to predict in-hospital mortality, prolonged length of stay (> 20 days) and major postoperative complications. A C statistic (receiver operating characteristic curve) was used to test discrimination of the EuroSCORE. Calibration of the model was assessed by the Hosmer-Lemeshow goodness-of-fit statistic. Results In-hospital mortality was 6.3%, and 21.7% of patients had one or more major complication. EuroSCORE showed very good discriminatory ability in predicting postoperative renal failure (C statistic: 0.78) and good discriminatory ability in predicting in-hospital mortality (C statistic: 0.72), prolonged length of stay (C statistic: 0.71), stroke over 24 h (C statistic: 0.73), gastrointestinal complications (C statistic: 0.73) and respiratory failure (C statistic: 0.71). There were no differences in terms of the discriminatory ability between standard and logistic EuroSCORE. The standard EuroSCORE model showed good calibration in predicting these outcomes (Hosmer-Lemeshow: p > 0.05). The logistic EuroSCORE model showed good calibration, except for prolonged length of stay and respiratory failure. Conclusion EuroSCORE can be used to predict not only in-hospital mortality, for which it was originally designed, but also prolonged length of stay and specific postoperative complications such as renal failure, stroke over 24 h, gastrointestinal complications and respiratory failure within the whole context of heart valve surgery. These outcomes can be predicted accurately using the standard EuroSCORE, which is very easily calculated.
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EuroSCORE Predicts Long-Term Mortality After Heart Valve Surgery
The Annals of thoracic surgery, 2005Co-Authors: Ioannis K Toumpoulis, Constantine E Anagnostopoulos, Stavros K Toumpoulis, Joseph J Derose, Daniel G SwistelAbstract:The European System for Cardiac Operative Risk Evaluation (EuroSCORE) is the most rigorously evaluated scoring system in cardiac surgery. We sought to evaluate the performance of EuroSCORE in the prediction of long-term mortality in patients undergoing heart valve surgery. Medical records of patients with isolated or combined heart valve surgery, who were discharged alive (n = 1035), were retrospectively reviewed. Their operative surgical risks were calculated according to EuroSCORE model (standard and logistic). Long-term survival data (mean follow-up 4.5 +/- 3.1 years) were obtained from the National Death Index. Kaplan-Meier curves of the quartiles of standard and logistic EuroSCORE were plotted. The estimated 5-year survival rates of the quartiles in the standard and logistic EuroSCORE model were: 90.0% +/- 2.3%, 85.1% +/- 2.3%, 64.8% +/- 3.3%, and 55.1% +/- 3.7% (p < 0.0001, log-rank test with adjustment for trend) and 90.4% +/- 2.2%, 86.4% +/- 2.5%, 66.9% +/- 3.3%, and 56.1% +/- 3.3% (p < 0.0001, log-rank test with adjustment for trend) respectively. The odds of death in the highest-risk quartile were 7.46- and 7.82-fold higher than the odds of death in the lowest-risk quartile for standard and logistic EuroSCORE respectively. EuroSCORE can be used to predict not only in-hospital mortality, for which it was originally designed, but also long-term mortality in the whole context of heart valve surgery. This outcome can be predicted using the standard EuroSCORE, which is very simple and easy in its calculation.
